Is it time to focus on ‘staff centred’ care?

Something that Jon Chapman, Director at Pinders said resonated with me: he suggested that care providers adopt a ‘staff centred’ approach to care.

Jon wrote an article a couple of years ago on this subject and he kindly agreed I could share it here.

Time to focus on ‘staff centred care?

I recently had the privilege of being a judge for one of the Caring Times Care Awards – forced to make the impossible selection of Care Home of the Year.

At a time when it’s easy to become depressed by the media’s fixation on bad news, it was refreshing to meet care providers with such obvious passion, energy and determination to enrich their residents’ lives.

Not surprisingly, each of the five finalists had achieved good and outstanding CQC ratings, which confirmed that they have successfully employed the systems and procedures to at least meet the required standards.  (That may sound like damning with faint praise but, unfortunately, inspectors can too often focus on rewarding compliance rather than excellence.  Sadly, the CQC attitude seems to be that existing safely is better than living well, forcing homes into a tick-box mentality.)

Of course, lots of homes achieve good inspection scores (the vast majority in fact), so what makes these finalists stand out from the crowd?  What really struck me about all of the representatives of these homes was their genuine love for what they do.  The owners, the managers and all of the staff (including the cooks, cleaners and gardeners) share the same sense of joy and a desire to make every day a good day for those in their care.  They love their jobs.

Of course, we didn’t just take their word for this.  It was evident from the numerous and effusive testimonials provided by residents and relatives that the passion was genuine, consistent and well-appreciated.

So, there seems to be an obvious conclusion – if you have happy staff you have happy residents, happy relatives and, even, happy inspectors.  I would equally suggest that an opposite correlation will result if your staff are unhappy.

Now, you may be thinking that’s pretty obvious, but I feel many operators have lost sight of this relationship within their homes, neglecting the well-being of their employees whilst expecting challenging jobs to be done, day after day, to an outstanding standard.

It amazes me when visiting some care homes how lowly valued the staff are.  By ‘valued’ I am not referring to monetary reward but to positive recognition of their efforts.  For example, I still see homes that have very poor, or even no, staff room facilities; a place to find some brief respite and recharge the batteries; a facility to change clothes or take a shower; a comfortable place to sit and read a book or chat with colleagues for a few minutes.

But it’s not just about facilities, it’s about valuing employees as people.  I recall a management training programme from the 1980s called ‘The One Minute Manager’ and its key message of “Catching people doing things right”.  Not chastising them for getting it wrong but making the effort to say ‘well done, I thought you handled that really well.”  When your job can be repetitive and challenging, such moments of genuine appreciation can lift and inspire.

Another lesson I learned from this little book was that money is rarely a motivating force.  And yet, it’s always the major topic of conversation in relation to staff recruitment and retention.  It is easy to blame the loss of employees on supermarkets prepared to pay higher hourly rates, but I think that’s missing the point.  Of course, money is important but it’s rarely the only reason people choose to switch jobs.  It could be that they’ve tried a care job and it’s not for them, or that they don’t enjoy where they work?  I would boldly suggest that if people enjoy their job, the lure of stacking shelves for a few pounds more isn’t going to be of appeal.

The proof of this can be seen in the many homes, like the award finalists, where the staff are paid the ‘going rate’ but love their jobs.  If you ask them why they find their roles rewarding, they won’t talk about how much, or how little, they are paid.  Conversely, there are homes where staff are paid more generously but view their job as simply a task to be completed, a tick to be entered in the right box.  They may be paid more but they don’t feel valued.

I have listened for many years to people talking about improving the perception of careers in the care sector but the basic culture seems to continue largely unchanged.  For example, the norm is still for payment to be by the hour.  Recently, I have met with two different operators who have each sought to challenge this status quo, offering employment to all their staff on a salaried basis.  As well as indicating a higher level of mutual trust, this can be advantageous to employees when seeking loans or mortgages.  Perhaps there is also a perception that people-with-jobs get paid by the hour whilst professionals-with-careers are salaried?

But such change isn’t easy, even when well-intentioned.  It was interesting to hear that both these employers had faced some initial suspicion to this change, strangely from their nursing staff who struggled to alter their fixation on comparing hourly rates of pay.  Positive change clearly needs to be a two-way street.  It will be fascinating to follow the experiences of these, and other, operators to see whether this approach helps with staff recruitment and retention.

At this stage, I suspect some readers will be thinking that my suggestion of ‘staff centred care is a lovely, fanciful idea but it’s bound to involve more cost and times are already tough.  But, rather than thinking you can’t afford to do this, I would suggest that the cost of not doing so could actually be far higher?

I find it staggering when I look at the accounts of some homes showing tens of thousands of pounds spent each year on recruitment fees, agency staff, CRB checks and training of the new staff required to replace those who have left.  We all know that finding good staff is a huge and costly challenge so why would you not want to do everything possible to keep the staff you employ?  They are your most valuable asset which needs looking after.  I still meet operators who moan about their rising agency costs whilst turning the staff room into another bedroom and telling me the staff should be grateful to have a job!

If staff retention is the biggest single business threat faced then CQC inspections has to be the second.  The impact of adverse ratings can be significant to the market perception of a home and, increasingly, on the viability and value of your business.  Getting it right has never been more important and the chances of doing so have to be dramatically improved if you have an enthusiastic and contented workforce.

I should make it clear that I’m not advocating any move away from ‘person centred care provision but I would question whether this may have become something of a cliché, to which all operators aspire but some are uncertain as to how it can actually be achieved?  There are many aspects that combine to achieve good care delivery but I think it’s reasonable to believe that staff will be more able to focus on the individual rather than the task if they feel positive about making a difference.

Of course, the correlation I’ve suggested between having happy staff and a great business may be pure coincidence – but why take the chance?

Jon Chapman, Pinders

To connect with Jon on LinkedIn, click here

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